Medicare RAC Summit
Medicare RAC Summit
Medicare RAC Summit
Medicare RAC Summit
Medicare RAC Summit
Medicare RAC Summit



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Agenda: Preconferences
Wednesday, July 20, 2016

Preconference registration optional; required for RAC Certificate Program
12:00 pm Registration Opens

PRECONFERENCE: THE POWER OF CLINICAL DOCUMENTATION IMPROVEMENT/CDI WITH PHYSICIAN ADVISOR LEADERSHIP -- TO TELL AN ENHANCED PATIENT STORY
(Registration optional -- required for the RAC Certificate program)
1:00 pm Exploring an Integrated Clinical Documentation Improvement (CDI) & Education Program

Learning Objective: Learn how to maximize the traditional CDI/coding and the UR/Pt status into one cross-trained point of education.
Day Egusquiza
President, AR Systems, Inc., Twin Falls, ID

    Speaker Bio

    Day Egusquiza is President of AR Systems, Inc. and brings over 30 years experience in health care reimbursement, hospital business office operations, contracting and compliance implementation. During her 20 years as Director of Revenue and Reimbursement at a community hospital in Idaho, she also was Director of a Physician Medical Management billing service, where she completed an integrated business office between a hospital and a large physician clinic. Her work includes providing guidance as a compliance & APC educator while providing operational insight on the revenue cycle impacts of RAC/Medicare Recovery Audit Contractors. Ms Egusquiza is a nationally recognized speaker on continuous quality improvement (CQI), benchmarking, redesigning, reimbursement systems and implementing an operational focus of compliance - both in hospitals and practices. She has been on the AAHAM National Advisory Council, HFMA National Advisory Council, and is a past President of the Idaho HFMA Chapter & recently received the Lifetime Achievement Award. Attendees at HFMA's ANI rated her in the top 25% for each year she has presented, earning her the 'Distinguished Speaker' award.
    Presentation Material (Acrobat)
1:30 pm CDI 2.0: This is Not Your Parent's CDI

Learning Objectives:
  1. Learn ways to structure the CDI program to maximize impact.
  2. Understand how the CDI program improves hospital-physician relationships to improve documentation and quality
Elizabeth Lamkin, MHA
CEO/Partner, PACE Healthcare Consulting, LLC, Bluffton, SC

    Speaker Bio

    Elizabeth Lamkin has over 25 years of experience in executive hospital administration. She has served as Chief Executive Officer and regional CEO for acute and post-acute hospitals and has served in teaching hospitals, and non-profit and investor owned sectors of healthcare. Ms. Lamkin consults on operational effectiveness and is a national speaker and author on operations, quality, utilization, and billing compliance. During her career she has achieved numerous awards for quality.

    Ms. Lamkin now has her own firm, PACE Healthcare Consulting, LLC offering strategy, operations, analytics and software solutions to hospitals, physicians and other sectors of healthcare.

    Ms. Lamkin holds a Master's in Healthcare Administration, from the University of South Carolina, Columbia, an ACHESA accredited Program and; BA Cum Laude, Core in Business Administration, from the University of South Carolina.
    Presentation Material (Acrobat)
2:00 pm Clinical Documentation and the Physician Advisor: Being Sure the Medical Words are Clinically Significant -- Words DO Matter when Justifying Inpatient Status

Learning Objectives:
  1. Communicate the role of explicit medical record documentation and its direct relationship to MS-DRG assignment.
  2. Discuss how explicit 'clinical judgement' documentation more accurately defines inpatient care that is "reasonable and necessary" to justify utilization of resources/intensity of services.
Betty B. Bibbins, MD, BSN, CHC, CI-CDI, CPEHR, CPHIT
Founder, CEO & Executive Physician Educator, DocuComp®LLC, Cape Charles, VA

    Speaker Bio

    Dr. Betty Bibbins, has over 35 years' experience as an educator, clinician and administrator. She is the Founder, CEO and Executive Physician Educator of DocuComp® LLC. DocuComp is a Clinical Documentation Improvement, Clinician Education, Medical Necessity and Compliance organization established in 2000.

    DocuComp® LLC established the first nationally recognized Physician Advisor Clinical Documentation Improvement & Integrity Certification Institute (PAC-CDI), Clinical Documentation Improvement & Integrity Certification Institute (C-CDI), and Denials Avoidance and Appeals Management Certification Institute (C-DAM).

    Dr. Bibbins has presented at numerous national and regional conferences and written many articles on physician documentation improvement. She has authored two books: "Essentials of Observation: The Basics" and "Inpatient (IPPS) Documentation Tips for Physicians-3rd Edition".

    She is Chair of the Association for Integrity in Health Care Documentation (AIHCD) and serves on The Advisory Board of the American College of Physician Advisors (ACPA).
    Presentation Material (Acrobat)
2:25 pm Break
2:45 pm Rescuing the Electronic Medical Record: Where is the Beef in your Progress Note?

Learning Objectives:
  1. The APSO note: learn how to use the right format to make the note readable.
  2. Learn how to avoid words that hurt your case and how to use the right language to make it meaningful.
Michael Salvatore, MD, FACP, CHCQM
Physician Advisor, Beebe Medical Center, Lewes, DE

    Speaker Bio

    Michael Salvatore, MD, FACP received his MD from the University of Arizona in 1977. His post-graduate training 1977 - 1982 was at Duke University. He practiced Critical Care Medicine for 30 years before becoming a full time PA at Beebe Healthcare in 2012. He has been married for 45 years and has 2 daughters. When not working as a PA, he is watching birds or walking the dog with his wife.
    Presentation Material (Acrobat)
3:15 pm Turning a Denial into an Improved Patient Story

Learning Objectives:
  1. Understand case studies of successful appeals.
  2. Gain realistic advice on navigating Commercial, Medicare, and Medicare Advantage denials.
Kim Frazier, DNP, MSN, RN, ACM
Manager of Utilization and Appeals, CaroMont Regional Medical Center; Adjunct Graduate Faculty, Blair School of Health, Queens University of Charlotte, Gastonia, NC

    Speaker Bio

    Dr. Frazier is a graduate of Presbyterian Hospital School of Nursing in Charlotte, NC. She went on to complete her BSN and MSN from Queens University of Charlotte and received her Doctor of Nursing Practice (DNP) from Gardner-Webb University in Boiling Springs, NC. She has been a nurse for 28 years in a variety of settings including Cardiovascular Recovery, SICU, Nursing Management and as a Nursing Director in a large Level I Trauma center in Charlotte, NC.

    The past 15 years have been spent in Case Management and Utilization Review. She is also adjunct faculty at Queens University of Charlotte, the Blair School of Health, Presbyterian School of Nursing. She currently is the Manager of Utilization Review and Appeals at CaroMont Regional Medical Center where she heads a team of 12 UR and Appeals staff and works with a fabulous Medical Director and Lead Physician Advisor and seven other physicians that help as PA's.
    Presentation Material (Acrobat)
3:45 pm Leveraging a PA with CDI to Tell a Story of Acuity

Learning Objectives:
  1. Understand the PA role with regard to coding accuracy.
  2. Learn how to ensure acuity is properly documented.
John Zelem
Vice President, Compliance and Physician Education (ACE), Executive Health Resources, an Optum Company, Newtown Square, PA

    Speaker Bio

    Dr. Zelem currently serves as Vice President, Compliance and Physician Education, for Executive Health Resources (EHR). At present, more than 2,300 hospital and healthcare organizations across the country are using EHR's solutions. A Board Certified general surgeon with more than 25 years of clinical experience, Dr. Zelem is responsible for quality assessment and improvement at EHR's client hospitals. Dr. Zelem is also a member of EHR's physician education team and regularly visits EHR's client hospitals to provide medical executives and staff members with ongoing education on a variety of topics including Medicare and Medicaid compliance and regulations, medical necessity, Recovery Audit Contractors, utilization review, denials management and length of stay. In addition, Dr. Zelem is a renowned industry author who has published many books and is a well-known motivational speaker and presents often to professional and public/patient audiences on health and wellness, personal development, and leadership and success.

    Prior to joining EHR, Dr. Zelem practiced general surgery at Griffin Hospital, a 160-bed acute care community hospital located in Derby, Conn., and then practiced general surgery at Baptist Memorial Hospital-Booneville, a 67-bed acute care hospital located in Booneville, Miss. Dr. Zelem received his medical degree from Boston University School of Medicine and bachelor's degree in biology from Boston College.
    Presentation Material (Acrobat)
4:15 pm

Q&A with Faculty

Day Egusquiza
President, AR Systems, Inc., Twin Falls, ID (Moderator)

    Speaker Bio

    Day Egusquiza is President of AR Systems, Inc. and brings over 30 years experience in health care reimbursement, hospital business office operations, contracting and compliance implementation. During her 20 years as Director of Revenue and Reimbursement at a community hospital in Idaho, she also was Director of a Physician Medical Management billing service, where she completed an integrated business office between a hospital and a large physician clinic. Her work includes providing guidance as a compliance & APC educator while providing operational insight on the revenue cycle impacts of RAC/Medicare Recovery Audit Contractors. Ms Egusquiza is a nationally recognized speaker on continuous quality improvement (CQI), benchmarking, redesigning, reimbursement systems and implementing an operational focus of compliance - both in hospitals and practices. She has been on the AAHAM National Advisory Council, HFMA National Advisory Council, and is a past President of the Idaho HFMA Chapter & recently received the Lifetime Achievement Award. Attendees at HFMA's ANI rated her in the top 25% for each year she has presented, earning her the 'Distinguished Speaker' award.
5:00 pm Preconference Adjournment
Networking Reception in the Exhibit Hall



Go to Agenda:
Day 1 | Day 2




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